Low-Dose Vaporized Cannabis Significantly Improves Neuropathic Pain

We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling medium-dose (3.53%), low-dose (1.29%), or placebo cannabis with the primary outcome being visual analog scale pain intensity.


Psychoactive side effects and neuropsychological performance were also evaluated. Mixed-effects regression models demonstrated an analgesic response to vaporized cannabis. There was no significant difference between the 2 active dose groups' results (P > .7).

Vaporize "Volcano"

The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo versus low-dose, 2.9 for placebo versus medium-dose, and 25 for medium- versus low-dose. As these NNTs are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being as effective a pain reliever as the medium dose. Psychoactive effects were minimal and well tolerated, and neuropsychological effects were of limited duration and readily reversible within 1 to 2 hours. Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain.

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Perspective

The analgesia obtained from a low dose of delta-9-tetrahydrocannabinol (1.29%) in patients, most of whom were experiencing neuropathic pain despite conventional treatments, is a clinically significant outcome. In general, the effect sizes on cognitive testing were consistent with this minimal dose. As a result, one might not anticipate a significant impact on daily functioning.




Bibliography:
Low-Dose Vaporized Cannabis Significantly Improves Neuropathic Pain
Barth Wilsey∗, , ,
Thomas Marcotte†,
Reena Deutsch†,
Ben Gouaux†,
Staci Sakai‡,
Haylee Donaghe‡
∗ VA Northern California Health Care System, and Department of Physical Medicine and Rehabilitation, University of California, Davis Medical Center, Sacramento, California
† Department of Psychiatry, University of California, San Diego, California
‡ Department of Anesthesiology and Pain Medicine, University of California, Davis Medical Center, Sacramento, California
Received 27 April 2012, Revised 26 August 2012, Accepted 21 October 2012, Available online 11 December 2012